title: Effect of the Kobe earthquake on stress and glycemic control in patients with diabetes mellitus.
abstract: OBJECTIVE
  To examine the effects of the Kobe, Japan, earthquake, a life-threatening event, on stress and glycemic control in diabetic patients.
  
  
  METHODS
  Hemoglobin A1c levels before and after the earthquake were evaluated in diabetic patients in Kobe (N = 157; magnitude, 7.2) and in Osaka, Japan, as a control (N = 277; magnitude, 4.2), where little damage to houses and traffic facilities occurred. Glycosylated hemoglobin levels were also compared with those of 2 years before and 1 year after the earthquake. The General Health Questionnaire (GHQ) and a self-administered questionnaire regarding damage to houses and relatives killed or injured were used to assess psychological and mental stresses on earthquake survivors.
  
  
  RESULTS
  Glycemic control was aggravated in diabetic patients after the earthquake in Kobe but not in Osaka. THe GHQ scores were significantly higher in the patients in Kobe than those in Osaka. Increased hemoglobin A1c concentrations and high scores on the GHQ were especially evident in diabetic patients with severe damage to houses and/or with relatives killed or injured.
  
  
  CONCLUSIONS
  These results suggest an association between chronic, life-threatening stress and the worsening of metabolic control in patients with diabetes mellitus.
authors.affiliation: Second Department of Internal Medicine, Kobe University School of Medicine, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Inui
authors.forename: H
authors.initials: H
authors.lastname: Kitaoka
authors.forename: M
authors.initials: M
authors.lastname: Majima
authors.forename: S
authors.initials: S
authors.lastname: Takamiya
authors.forename: M
authors.initials: M
authors.lastname: Uemoto
authors.forename: C
authors.initials: C
authors.lastname: Yonenaga
authors.forename: M
authors.initials: M
authors.lastname: Honda
authors.forename: K
authors.initials: K
authors.lastname: Shirakawa
authors.forename: N
authors.initials: N
authors.lastname: Ueno
authors.forename: K
authors.initials: K
authors.lastname: Amano
authors.forename: S
authors.initials: S
authors.lastname: Morita
authors.forename: A
authors.initials: A
authors.lastname: Kawara
authors.forename: K
authors.initials: K
authors.lastname: Yokono
authors.forename: M
authors.initials: M
authors.lastname: Kasuga
authors.forename: H
authors.initials: H
authors.lastname: Taniguchi
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000097:blood* / Q000523:psychology*; D004190:Disasters; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin